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| Name | Laparoscopic Uterosacral Ligament Suspension at Time of Hysterectomy: A Stepwise Approach |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 23-12-2022 22:12:02 |
| Video Discription | This educational video demonstrates a laparoscopic uterosacral ligament suspension technique performed during hysterectomy, designed to prevent apical prolapse. The video details the procedural steps and advantages of the laparoscopic method, including improved visualization and precision in suture placement which potentially reduces the risks of ureteric injury and recurrence of prolapse, compared to traditional vaginal techniques. Read the full transcript here: https://cansagevideos.com/cansage-2022-56-laparoscopic-uterosacral-ligament-suspension-at-time-of-hysterectomy-a-stepwise-approach/ Presented By: Dr. Angela Deane Dr. Sara Houlihan Dr. Abheha Satkunaratnam Dr. Cici Zhu Affiliations: University of Toronto Timestamps (00:06) Objectives (00:23) Advantages (00:56) Comparing Outcomes of Laparoscopic vs Vaginal Uterosacral Ligament Suspension (USLS) (01:57) Steps to Laparoscopic USL Suspension (02:27 - 04:32) Procedure Video (04:32 - 06:11) Steps to Laparoscopic USL Suspension The video provides an in-depth tutorial on the laparoscopic uterosacral ligament suspension technique utilized during a hysterectomy, emphasizing its role in addressing apical prolapse. The laparoscopic approach offers significant advantages over the vaginal method, such as enhanced visualization of the pelvic anatomy, which helps in precise dissection and minimizes the risk of damaging critical structures like the ureter and hypogastric nerve. Additionally, this approach allows surgeons to secure the uterosacral ligament more effectively than the vaginal approach, particularly in its proximal aspect, which is crucial for preventing prolapse recurrence. A retrospective review comparing laparoscopic and vaginal uterosacral ligament suspension in 206 patients highlighted the benefits of the laparoscopic approach. It showed no cases of ureteric obstruction, lower rates of postoperative urinary retention, a higher completion rate of adnexal surgery (over 98%), and a reduced recurrence of prolapse compared to the vaginal group. These outcomes suggest that the laparoscopic approach not only enhances the surgical effectiveness but also improves postoperative recovery. The video meticulously describes each step of the laparoscopic procedure, starting from the laparoscopic suture of the proximal uterosacral ligament, followed by the transvaginal colpotomy and ligation of the distal uterosacral ligaments. It demonstrates how to handle the prolene sutures through both the abdominal and vaginal phases, ensuring that the vaginal vault is adequately suspended without tension. The final steps include closure of the vaginal vault, anterior repair, and a crucial cystoscopy to ensure ureteral patency before concluding the surgery. This stepwise approach not only serves as a practical guide for surgeons but also reinforces the procedural integrity and safety of laparoscopic uterosacral ligament suspension during hysterectomy. |
| Category | People & Blogs |
| Tags | Uterosacral Ligament Suspension | Hysterectomy | Stepwise Approach | apical prolapse | laparoscopic approach | pelvic floor supporting defects | laparoscopic | concomitant adnexal surgery completion | uterosacral ligament |
